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Ethical dilemmas: How should I... support staff with long covid?

Data from the ONS estimate that long Covid symptoms are adversely affecting the day-to-day activities of around 1.5 million people in the UK. What do you do if one of your team is affected?

Fatigue is the most common symptom reported as part of the experience of long Covid, followed by difficulty concentrating, shortness of breath and muscle ache. 

These health conditions can affect people’s home and social lives, as well as their ability to work, but they also create challenges for employers. So how should you support a staff member living with long Covid?

Reasonable adjustments

“Employees are human beings, not so-called ‘human resources’, so successfully managing an individual is like any other healthy relationship,” says Paul Day, director of the Pharmacists’ Defence Association (PDA, below). 

“Rather than start with a mindset of ‘this is how I deal with everyone, therefore you must comply with my only model of interactions and behaviour’, you listen and try to understand the other person, and do what you can to tailor your interaction appropriately. 

“So, if an employee or locum needs to have things a bit different, good employers and competent managers naturally adjust arrangements to enable that. 

“A can-do attitude and creative approach may help, but it shouldn’t be rocket science. If someone needs a stool to rest on, or extra or different breaks, or to ask others to do certain tasks, which could be something as simple as reaching the top shelf – why wouldn’t that be accommodated? 

“Failure to provide reasonable adjustments doesn’t just expose management incompetence and show the rest of the team how they too might be treated if they ever needed support,” warns Day.

“The Equality Act 2010 defines disability as a ‘physical or mental impairment…[that] has a substantial and long-term adverse effect on [their] ability to carry out normal day-to-day activities’, and Government guidance makes clear that ‘long-term’ means 12 months or more – so having long Covid may also be
a protected characteristic.”

Rather than having to argue that in court, Day encourages employers to just “do the right, caring, human thing” in the first place, adding: “The Government may help with any costs and, if they don’t know about it already, employers should familiarise themselves with the Access to Work scheme at gov.uk/access-to-work.”

Rather than start with a mindset of ‘this is how I deal with everyone, therefore you must comply with my only model of interactions and behaviour’, you listen and try to understand the other person, and do what you can to tailor your interaction appropriately.

The regulatory angle

“From my perspective as a regulatory lawyer there are two key issues here,” says Andrea James, healthcare regulatory partner at Keystone Law. 

“Firstly is the question of whether the staff member – if they are a GPhC regulated professional – has adverse physical or mental health that impacts upon their fitness to practise. That may be the case if their health condition impairs their ability to carry out the duties of a pharmacist or pharmacy technician in a safe and effective manner, thereby posing a potential risk to patient safety.

“The GPhC should be informed of such health conditions, although it is important to emphasise that the vast majority of health conditions do not result in any kind of formal GPhC process.”

James says the second issue is that pharmacy owners need to be aware that the equality-related regulatory obligations imposed upon them by the GPhC go beyond that which is required by the law. 

“The GPhC recently [December 2022] updated its equality guidance and was keen to emphasise this point, noting: ‘We expect you to take whatever steps you need to run your pharmacy in a way that encourages equality of opportunity and respect for diversity…You must act with integrity and honesty and in a way that is fair, inclusive and transparent’. 

“We do see cases where, although the employee has failed in an employment tribunal claim, the regulator proceeds with fitness to practise proceedings against the manager or employer involved, as the standard required by regulators such as the GPhC is so much higher than that required by employment law.” 

We do see cases where, although the employee has failed in an employment tribunal claim, the regulator proceeds with fitness to practise proceedings against the manager or employer involved, as the standard required by regulators such as the GPhC is so much higher than that required by employment law.

Communication and support

Typically in the UK, phased returns to work last for about four weeks. This allows most people who have been unwell to build up to where they were prior to falling ill. 

“However, the standard phased return to work may not be long enough for long Covid sufferers,” according to the information and enquiries team at Pharmacist Support – the profession’s independent charity – “as extreme fatigue is the most common reported symptom. In this case, a longer phased return to work may need to be considered.”

The charity says communication here is key, and you should ask the person returning what sort of help they will need. Things you should consider include:

  • How many hours a day are practical for them
  • What their main symptoms are
  • How to manage relapses.

Flexibility is also important and sometimes the smallest adjustments can make a difference.

  • Can you provide a chair so that they can rest if needed?
  • Is there any work that can be done from home?
  • If they have a long commute, can you put them in a branch that is closer to home?

“It is also important to consider the impact any changes may have on other members of the pharmacy team”, adds the charity, “so conversations are encouraged to ensure that all staff feel supported, and encourage your team to think about their own well-being, both as individuals and as a group. 

“There can be a definite psychological toll to not feeling well for a long time, so finding ways to stay connected to others and do things you love – perhaps finding ways to adapt your hobbies – can be important. Counselling and peer support can also be useful in terms of finding ways to cope psychologically with the effects of feeling ill long-term.” 

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